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A nurse is developing a plan of care for a client newly diagnosed with bulimia nervosa. Which of the following would the nurse expect to implement in conjunction with pharmacologic therapy?
- A. Behavioral therapy
- B. Cognitive behavioral therapy
- C. Interpersonal therapy
- D. Family therapy
Correct Answer: B
Rationale: Cognitive behavioral therapy (CBT) (B) is the most effective non-pharmacologic treatment for bulimia nervosa, addressing distorted thoughts and behaviors. Behavioral therapy (A) is less specific, interpersonal (C) and family (D) therapies are adjunctive.
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The nurse is preparing to discharge a client who has been hospitalized with anorexia nervosa. Which of the following would the nurse include in the teaching plan?
- A. Knowing the calorie content of numerous foods
- B. Learning strategies to control impulses
- C. Describing physiologic consequences of anorexia nervosa
- D. Setting realistic goals
Correct Answer: D
Rationale: Setting realistic goals (D) supports recovery by promoting achievable steps toward healthy eating and weight restoration. Calorie knowledge (A) may reinforce obsessive behaviors, impulse control (B) is less specific, and describing consequences (C) is informative but not action-oriented.
The nurse is planning to explain the purpose of the behavioral therapy technique of self-monitoring to a client with bulimia nervosa. The nurse would emphasize keeping a diary to record which of the following?
- A. Feelings of hunger
- B. Efforts at distraction
- C. Environmental stimuli
- D. Rigid rules about eating
Correct Answer: C
Rationale: Self-monitoring in bulimia nervosa involves recording environmental stimuli (C) to identify triggers for binge-purge behaviors. Hunger (A), distraction (B), and rigid rules (D) are less directly tied to the core goal of trigger identification.
A client with bulimia nervosa is being treated at an outpatient clinic and is prescribed a selective serotonin reuptake inhibitor (SSRI). Which of the following would the nurse include when teaching the client about the prescribed medication?
- A. Closely monitor your fluid intake while taking this medication.
- B. Stop taking this medication if it causes weight gain.
- C. Expect menstrual irregularities, particularly if they?ve occurred previously.
- D. Report any weight changes that occur during the first few weeks this medication is taken.
Correct Answer: D
Rationale: SSRIs for bulimia nervosa can cause weight changes, and reporting these early (D) is important for monitoring and adjusting treatment. Fluid intake (A) is not typically monitored, stopping for weight gain (B) is inappropriate, and menstrual irregularities (C) are not a primary concern.
While caring for a client with anorexia nervosa, the nurse anticipates that the client would have difficulty making which of the following comments?
- A. I?m mad at you because you won?t let me go on a pass unless I gain weight!
- B. I need to have everything in its place and perfect.
- C. If I gain a pound, I?ll just keep gaining weight.
- D. I am very involved in preparing my food and counting calories.
Correct Answer: A
Rationale: Clients with anorexia nervosa often struggle to express anger directly (A) due to emotional suppression and fear of conflict. Statements about perfectionism (B), fear of weight gain (C), and food preoccupation (D) are typical and align with the disorder?s characteristics.
A nursing instructor is reviewing the various theories related to anorexia nervosa. Which of the following would the instructor include when describing theories related to the biologic domain? Select all that apply.
- A. Genetic vulnerability
- B. Separation-individuation
- C. Role pressures
- D. Dieting leading to starvation
- E. Pursuit of thinness
- F. Decreased serotonin activity
Correct Answer: A,F
Rationale: Biologic theories for anorexia nervosa include genetic vulnerability (A) and decreased serotonin activity (F), linked to appetite and mood regulation. Separation-individuation (B), role pressures (C), and pursuit of thinness (E) are psychosocial, and dieting (D) is behavioral.